Leads with high resistive surface

ABSTRACT

Implantable medical leads having resistance characteristics adapted to dissipate radio frequency (RF) electromagnetic energy during medical procedures such as magnetic resonance imaging (MRI) are disclosed. An illustrative medical device includes a lead having an inner electrical conductor operatively coupled to an electrode and a pulse generator, and one or more outer resistive shields that radially surround the inner conductor and dissipate RF energy into the surrounding body tissue along the length of the lead.

CROSS-REFERENCE TO RELATED APPLICATION

This application is a continuation of U.S. application Ser. No.12/329,257, filed on Dec. 5, 2008, which claims priority under 35 U.S.C.§119 to U.S. Provisional Application No. 60/992,915, filed on Dec. 6,2007, entitled “Leads With High Resistive Surface,” which areincorporated herein by reference in their entirety.

TECHNICAL HELD

The present invention relates to implantable medical devices. Morespecifically, the present invention relates to implantable medical leadshaving impedance characteristics adapted to dissipate radio frequency(RF) electromagnetic energy during medical procedures such as magneticresonance imaging (MRI).

BACKGROUND

Magnetic resonance imaging (MRI) is a non-invasive imaging procedurethat utilizes nuclear magnetic resonance techniques to render imageswithin a patient's body. Typically, MRI systems employ the use of amagnetic coil having a static magnetic field strength of between about0.2 to 3 Teslas. During the procedure, the body tissue is brieflyexposed to RF pulses of electromagnetic energy in a plane perpendicularto the magnetic field. The resultant electromagnetic energy from thesepulses can be used to image the body tissue by measuring the relaxationproperties of the excited atomic nuclei in the tissue.

During imaging, the electromagnetic radiation produced by the MRI systemmay be picked up by implantable device leads used in implantable medicaldevices such as pacemakers or cardiac defibrillators. This energy may betransferred through the lead to the electrode in contact with thetissue, which may lead to elevated temperatures at the point of contact.The degree of tissue heating is typically related to factors such as thelength of the lead, the conductivity or impedance of the lead, and theshape and surface area of the lead electrodes. In some cases, exposureto electromagnetic energy may also induce an undesired voltage on thelead.

SUMMARY

The present invention relates to implantable medical leads havingimpedance characteristics adapted to dissipate RF electromagnetic energyduring medical procedures such as magnetic resonance imaging (MRI). Anillustrative implantable medical device (IMD) configured for use in amagnetic resonance imaging environment includes a lead having an innerelectrical conductor operatively coupled to an electrode, and at leastone resistive shield that radially surrounds the inner electricalconductor along all or a portion of the length of the lead. The innerelectrical conductor can comprise a material having a relatively lowresistance to facilitate energy transmission of IMD electrical signalsthrough the conductor to the lead electrode. The inner conductor mayhave a relatively low impedance at the IMD such that it does notattenuate electrical energy transmitted by the IMD (e.g., electricalpulses transmitted by a pulse generator).

The outer resistive shield has a resistance that is relatively large incomparison to the resistance of the inner conductor, which dissipates RFelectromagnetic energy received on the lead during an MRI scan along thelength of the lead. In some embodiments, the outer resistive shieldincludes a layer or coating of resistive material radially disposedabout at least a portion of the inner conductor. In other embodiments,the outer resistive shield includes a helically-shaped coil radiallydisposed about at least a portion of the inner conductor. The resistiveshield can comprise a single resistive shield that extends continuouslyalong the length of the lead, or can comprise multiple resistive shieldseach spaced apart from each other along the length of the lead via agap, which serves to electrically isolate the resistive shields fromeach other. In use, the resistive shields minimize the energy pickup bythe inner portion of the lead, and the high impedance of the shields atthe frequency of the MRI RF energy minimizes the transfer of any energypicked up by the lead to the lead electrode.

A medical device in accordance with another illustrative embodimentincludes a lead having an electrical conductor wire operatively coupledto an electrode. The conductor wire can vary in resistivity eithercontinuously or at one or more locations across the width of the leadsuch that an outer portion of the conductor has a greater resistivitythan the resistivity at a center portion of the conductor. In someembodiments, for example, the conductor wire includes an inner conductorcore surrounded radially by one or more outer resistive shieldsconfigured to dissipate RF electromagnetic energy along the length ofthe lead. In other embodiments, the resistivity of the conductor wirevaries continuously across its width between the center portion and theouter portion.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic view of an illustrative medical device having alead implanted within the body of a patient;

FIG. 2 is a schematic view showing a simplified equivalence circuit forthe lead of FIG. 1;

FIG. 3 is a longitudinal cross-sectional view showing a portion of thelead of FIG. 1 in greater detail;

FIG. 4 is a transverse cross-sectional view showing the lead across line4-4 in FIG. 3;

FIGS. 5 and 6 are longitudinal and transverse cross-sectional views,respectively, showing the energy flow path of RF electromagnetic energyreceived on the lead of FIGS. 3-4 in the presence of an MRI field;

FIG. 7 is a transverse cross-sectional view showing a lead in accordancewith another illustrative embodiment having a low thermal impedanceinsulator radially disposed about the resistive shield;

FIG. 8 is a traverse cross-sectional view showing a lead in accordancewith another illustrative embodiment having a gradual change inresistance across its width;

FIG. 9 is a transverse cross-sectional view showing a lead in accordancewith another illustrative embodiment having multiple layers ofconductors each with a different resistivity;

FIG. 10 is a longitudinal cross-sectional view showing a lead inaccordance with another illustrative embodiment having an insulatorbetween the resistive shield and the inner conductor;

FIG. 11 is a transverse cross-sectional view showing the lead acrossline 11-11 in FIG. 10;

FIG. 12 is a longitudinal cross-sectional view showing a lead inaccordance with another illustrative embodiment having a number ofresistive shields spaced apart and electrically isolated from each otheralong the length of the lead;

FIG. 13 is another longitudinal cross-sectional view of the lead of FIG.12, showing the energy flow path of the RF electromagnetic energyreceived by the lead in the presence of an MRI field;

FIG. 14 is a longitudinal cross-sectional view showing a lead inaccordance with another illustrative embodiment having ahelically-shaped inner conductor coil surrounded by a resistive shield;

FIG. 15 is a longitudinal cross-sectional view showing a lead inaccordance with another illustrative embodiment having a number ofresistive shields spaced apart and electrically isolated from each otheralong the length of the lead;

FIG. 16 is a longitudinal cross-sectional view showing a lead inaccordance with another illustrative embodiment having ahelically-shaped inner conductor coil surrounded by a helically-shapedresistive coil;

FIG. 17 is a longitudinal cross-sectional view showing a lead inaccordance with another illustrative embodiment having ahelically-shaped inner conductor coil and a number of helically-shapedresistive coils spaced apart and electrically isolated from each otheralong the length of the lead;

FIG. 18 is a longitudinal cross-sectional view showing a lead inaccordance with another illustrative embodiment having ahelically-shaped conductor coil with an integrated restive shield;

FIG. 19 is a transverse cross-sectional view showing the configurationof the helical conductor coil of FIG. 18 in greater detail;

FIG. 20 is a transverse cross-sectional view showing anotherhelically-shaped conductor coil with an integrated resistive shield; and

FIG. 21 is a chart showing the interdependence of coil pitch and coildiameter on the amount of RF energy absorbed by a helically-shaped wirecoil conductor.

While the invention is amenable to various modifications and alternativeforms, specific embodiments have been shown by way of example in thedrawings and are described in detail below. The intention, however, isnot to limit the invention to the particular embodiments described. Onthe contrary, the invention is intended to cover all modifications,equivalents, and alternatives falling within the scope of the inventionas defined by the appended claims.

DETAILED DESCRIPTION

FIG. 1 is a schematic view of an illustrative medical device 12 having alead implanted within the body of a patient. In the illustrativeembodiment depicted, the medical device 12 comprises a pulse generatorimplanted within the body. The medical device 12 can be coupled to alead 14 inserted into the patient's heart 16. The heart 16 includes aright atrium 18, a right ventricle 20, a left atrium 22, and a leftventricle 24. The pulse generator 12 can be implanted subcutaneouslywithin the body, typically at a location such as in the patient's chestor abdomen, although other implantation locations are possible.

A proximal portion 26 of the lead 14 can be coupled to or formedintegrally with the pulse generator 12. A distal portion 28 of the lead14, in turn, can be implanted at a desired location within the heart 16such as in the right ventricle 20, as shown. Although the illustrativeembodiment depicts only a single lead 14 inserted into the patient'sheart 16, in other embodiments, however, multiple leads can be utilizedso as to electrically stimulate other areas of the heart 16. In someembodiments, for example, the distal portion of a second lead (notshown) may be implanted in the right atrium 18. In addition, or in lieu,another lead may be implanted at the left side of the heart 16 (e.g., inthe coronary veins) to stimulate the left side of the heart 16. Othertypes of leads such as epicardial leads may also be utilized in additionto, or in lieu of, the lead 14 depicted in FIG. 1.

During operation, the lead 14 can be configured to convey electricalsignals between the heart 16 and the pulse generator 12. For example, inthose embodiments where the pulse generator 12 is a pacemaker, the lead14 can be utilized to deliver electrical therapeutic stimulus for pacingthe heart 16. In those embodiments where the pulse generator 12 is animplantable cardiac defibrillator, the lead 14 can be utilized todeliver electric shocks to the heart 16 in response to an event such asa heart attack. In some embodiments, the pulse generator 12 includesboth pacing and defibrillation capabilities.

FIG. 2 is a schematic view showing a simplified equivalence circuit 30for the lead 14 representing the RF energy picked up on the lead 14resulting from RF electromagnetic energy produced by an MRI scanner. Asshown in FIG. 2, Vi 34 in the circuit 30 represents an equivalent sourceof energy picked up by the lead 14 from the MRI scanner.

During magnetic resonance imaging, the length of the lead 14 functionssimilar to an antenna, receiving the RF energy that is transmitted intothe body from the MRI scanner. Voltage 34 in FIG. 2 may represent, forexample, the resultant voltage received by the lead 14 from the RFenergy. The RF energy picked-up by the lead 14 may result, for example,from the rotating RF magnetic field produced by an MRI scanner, whichgenerates an electric field in the plane perpendicular to the rotatingmagnetic field vector in conductive tissues. The tangential componentsof these electric fields along the length of the lead 14 couple to thelead 14. The voltage Vi 34 is thus equal to the integration of thetangential electric field (i.e., the line integral of the electricfield) along the length of the lead 14.

The ZI parameter 32 in the circuit 30 represents the equivalentimpedance exhibited by the lead 14 at the RF frequency of the MRIscanner. The impedance value ZI 32 may represent, for example, theinductance or the equivalent impedance resulting from the parallelinductance and the coil turn by turn capacitance exhibited by the lead14 at an RF frequency of 64 MHz for a 1.5 Tesla MRI scanner, or at an RFfrequency of 128 MHz for a 3 Tesla MRI scanner. The impedance ZI of thelead 14 is a complex quantity having a real part (i.e., resistance) andan imaginary part (i.e., reactance).

Zb 38 in the circuit 30 may represent the impedance of the body tissueat the point of lead contact. Zc 36, in turn, may represent thecapacitive coupling of the lead 14 to surrounding tissue along thelength of the lead 14, which may provide a path for the high frequencycurrent (energy) to leak into the surrounding tissue at the RF frequencyof the MRI scanner. Minimizing the absorbed energy (represented bysource Vi 34) reduces the energy that is transferred to the body tissueat the point of lead contact with the tissue.

The circuit represented in FIG. 2 and the associated equation describedbelow are for the purpose of illustrating the concept of lead heating inan MRI environment. At frequencies where the wavelength of inducedvoltage (or current) is dose to the size of the circuit, a simple lumpedsum system such as that illustrated in FIG. 2 may not accurately modelthe behavior of the lead 14 in the MRI environment. Consequently, inthose circumstances, a distributed model should be used along withMaxwell's equation for a proper mathematical description of the circuit.In some cases, the approximating distributed model can be created usingfield solvers or simulators.

As can be further seen in FIG. 2, the lead 14 has some amount of leakage36 into the surrounding tissue at the RF frequency of the MRI scanner.As further indicated by 38, there is also an impedance at the point ofcontact of the lead electrode to the surrounding body tissue within theheart 16. The resulting voltage Vb delivered to the body tissue may berelated by the following formula:

Vb=Vi Zbe/(Zbe+ZI), where Zbe=Zb in parallel with Zc.

The temperature at the tip of the lead 14 where contact is typicallymade to the surrounding tissue is related in part to the powerdissipated at 38 (i.e., at “Zb”), which, hi turn, is related to thesquare of Vb. To minimize temperature rises resulting from the powerdissipated at 38, it is thus desirable to minimize Vi (34) and Zc (38)while also maximizing the impedance of the lead ZI (32). In someembodiments, the impedance ZI (32) of the lead 14 can be increased atthe RF frequency of the MRI scanner, which aids in reducing the powerdissipated into the surrounding body tissue at the point of contact 38.

In some embodiments, the impedance of the lead 14 can be increased byadding inductance to the lead 14 and/or by a suitable constructiontechnique. For example, the inductance of the lead 14 can be increasedby increasing the diameter of the conductor coil and/or by decreasingthe pitch of the conductor coil. Decreasing the coil pitch may result inincreasing capacitance between successive turns of the coil (i.e., coilturn by turn capacitance). The parallel combination of inductance (fromthe helical shape of the coil) and the turn by turn capacitanceconstitutes a resonance circuit. For a helically coiled leadconstruction, if the resonance frequency of the lead is above the RFfrequency of the MRI, then the helical coil acts as an inductor. For aninductor, increasing the cross section of the coil area and/or reducingthe coil pitch increases the inductance and, as a result, increases theimpedance of the lead 14.

Similar to an antenna, the energy pickup from a lead is related to itsresonance length with respect to the wavelength of the frequency ofinterest. For example, for a dipole antenna, the antenna is consideredtuned, or at resonance, when the antenna length is half the wavelengthor an integer multiple of the wavelength. At resonance lengths, theenergy pickup of the antenna is maximized. In a similar manner, and insome embodiments, the lead 14 can be detuned so as to prevent resonancewithin the lead 14, and thus minimize the voltage Vi. For theillustrative embodiment shown in FIG. 1, for example, the lead 14functions as an antenna having a resonance frequency at lengthL=integer×λ/2. In some embodiments, the length of the lead 14 and/or theconstruction parameters of the lead 14 affecting the wavelength can bechosen so as to avoid resonance within the lead 14.

In some embodiments, in addition to detuning the length of the lead 14with respect to the wavelength of the MRI induced RF energy, shieldingcan also be added to the lead 14 to further reduce the amount ofelectromagnetic energy picked-up from the lead 14. For example, theenergy picked up from the shielding can be coupled to the patient's bodyalong the length of the lead 14, preventing the energy from coupling tothe lead tip. The transfer of intercepted energy by the shielding alongthe length of the shielding/lead can also be inhibited by dissipatingthe energy as resistive loss, using resistive material for the shieldingconstruction.

FIG. 3 is a longitudinal cross-sectional view showing a portion of thelead 14 of FIG. 1 in greater detail. FIG. 4, in turn, is a transversecross-sectional view showing the lead 14 across line 4-4 in FIG. 3. Asshown in FIGS. 3-4, the lead 14 includes an inner conductor core 40 andan outer resistive shield 42 that radially surrounds the inner conductor40 along at least a portion of the length of the lead 14. The innerconductor core 40 may function as an electrical conduit for supplyingenergy from the pulse generator 12 to one or more electrodes (not shown)located on the distal portion 28 of the lead 14. In those embodimentswhere the lead 14 is a bradycardia lead, for example, the innerconductor core 40 may serve as an electrical conduit for supplyingtherapeutic energy to one or more electrodes used for pacing thepatient's heart 16 and/or for sensing electrical activity occurringwithin the heart 16. Alternatively, in those embodiments where the lead14 is a tachycardia lead, the inner conductor core 40 may serve as anelectrical conduit for supplying shocking energy to one or moreelectrodes coils located on the distal portion 28 of the lead 14.Although a single inner conductor core 40 is shown in the embodiment ofFIGS. 3-4, in other embodiments multiple inner conductors may beprovided for transmitting electrical energy to multiple pacing/senseelectrodes located on the lead 14.

In the illustrative embodiment of FIGS. 3-4, the lead 14 has asubstantially coaxial configuration with the inner conductor core 40extending co-linearly with the outer resistive shield 42 along all or aportion of the length of the lead 14. In other embodiments, the innerconductor core 40 can comprise a helically-shaped conductor coil (ormultiple co-radially wound helically-shaped conductors) extendingthrough the Interior of the outer resistive shield 42 along all or aportion of the length of the lead 14.

The outer resistive shield 42 can comprise a layer or coating ofresistive material that radially surrounds the inner conductor core 40.In one embodiment, for example, the outer resistive shield 42 comprisesa resistive jacket that is formed integrally with the inner conductor 40(e.g., as a single conductor) that radially surrounds the innerconductor core 40. In some embodiments, the lead 14 may further includea layer or coating of insulative material about the resistive shield 42to electrically isolate the conductor core 40 from the surrounding bodytissue and blood. In further embodiments discussed herein in which thereis a layer or coating of insulation between the conductor and theresistive shield, the layer or coating of insulative material disposedabout the resistive shield 42 may be omitted, provided the length of theconductor is sufficiently small.

The outer resistive shield 42 may have a relatively high resistance hicomparison to the inner conductor core 40 in order to facilitatedissipation of RF electromagnetic energy received along the length thelead 14, which can cause heating of body tissue in contact with the lead14. In some embodiments, for example, the ratio of the resistance of theouter resistive shield 42 to the resistance of the inner conductor core40 may be in the range of between about 2 to 10. An example resistanceof the outer resistive shield 42 may be approximately 1 kΩ for a 50 cmlong length of lead, although other values are possible.

In some embodiments, the difference in the resistance between the outerresistive shield 42 and the inner conductor core 40 can depend at leastin part on the type of material(s) used, the dielectric constant ofthose materials, as well as other factors. In certain embodiments, forexample, the inner conductor core 40 comprises a relative low resistancematerial configured to facilitate low-energy transmission of electricalsignals along the core 40 whereas the outer resistive shield 42comprises a relatively high resistance material configured to dissipateRF electromagnetic energy received on the lead 14 along the length ofthe lead 14 during magnetic resonance imaging. High resistance materialssuitable for use as an outer resistive shield 42 can include, forexample, metals, conductive polymers, and/or composite materials. In oneexemplary embodiment, the inner conductor core 40 is a silver-filledMP35N wire containing approximately 28% to 30% silver whereas the outerresistive shield 42 comprises a layer or coating (e.g., a tubularjacket) of a different, more resistive material. An example conductivepolymer suitable for use as the outer resistive shield 42 ispolyphenylenevinylene or polyfluorene.

Although a higher conductivity shield generally provides bettershielding of the inner conductor, and also permits thinner shielding tobe used due to the lower skin depth, the higher conductivity of suchshielding may also transfer the RF energy more easily along the lengthof the lead. Thus, even though the RF energy does not couple from theshield to the inner conductor, the shield itself may transfer the RFenergy along the length of the lead towards the electrode at the leadtip. At or near the electrode, this high concentration of energy eitherdirectly heats the surrounding tissue (e.g., by capacitively coupling tothe tissue), or couples the energy back to the lead where the innerconductor is exposed and contacts the tissue.

FIGS. 5 and 6 are longitudinal and transverse cross-sectional views,respectively, showing the energy flow path of RF electromagnetic energyreceived on the lead 14 of FIGS. 3-4 in the presence of an MRI field. Asshown in FIGS. 5 and 6, RF energy transmitted into the patient's bodyduring magnetic resonance imaging is received along the length of thelead 14, which acts as an antenna. Due to the “skin effect” property inconductive wires, in which alternating currents are limited toconduction at or near the surface of a conductor, the resistanceincreases towards the center of the lead. The increase of the resistanceof the shield toward the center may also be enhanced by providinginsulating material about the shielding in some embodiments. As energytravels along the length of the lead 14, as indicated generally byreference arrows 46, the magnitude of the energy is reduced (due todissipation), and the dissipated energy is converted to heat along thelength of the lead 14. This can be seen generally by the reduction inthe vector length of the arrows 46 from left to right in FIG. 5. As canbe further seen in FIG. 6, the energy 46 takes the lowest impedance pathof the resistive shield 42 instead of coupling to the inner conductor 40due to the skin effect. Because the RF energy is dissipated along thelength of the lead 14 and not at the electrode/body tissue interface,the heat absorbed by the lead from the RF energy is attenuated along thelength of the lead 14.

FIG. 7 is a transverse cross-sectional view showing a lead 48 inaccordance with another illustrative embodiment having a low-thermalimpedance insulator radially disposed about the resistive shield. Thelead 48 is similar to the lead 14 described with respect to FIGS. 3-4,including an inner conductor core 50 that can be used as an electricalconduit for supplying energy to one or more electrodes on the lead 48,and an outer resistive shield 52 having a relatively high resistancecompared to the resistance of the inner conductive core 50 fordissipating RF electromagnetic energy along the length of the lead 48.

In the embodiment of FIG. 7, the lead 48 further includes a low thermalimpedance insulator 54 adapted to transfer heat generated along thelength of the lead 48 at the lead/tissue interface. In some embodiments,the insulator 54 comprises a layer or coating of an insulative materialradially disposed about the outer resistive shield 52. In certainembodiments, for example, the insulator 54 is a thin layer or coating ofsilicone or polyurethane, although other configurations are possible. Inother embodiments, the insulator 54 is a thin layer or coating of metalradially disposed about the outer resistive shield 52. In someembodiments, the thickness of the metal insulator 54 is within the rangeof between about 10 μm to about 10,000 μm, although other configurationsare possible.

In some embodiments, the material used for the insulator 54 has arelatively high dielectric constant in the range of between about 6 to100. In sonic embodiments, the relatively high dielectric constant forthe insulator material can be achieved by adding carbon particles, boronnitride particles, aluminum oxide particles, or the like to theinsulator material. The insulator 54 can have a gradient of thedielectric constant that is constant along the length of the lead 48,constant across the width (or transverse cross section) of the lead 48,or a combination of both. During magnetic resonance imaging, theproperties of the insulator 54, including its thickness, dielectricconstant, or a combination of both, can provide a means for transferringelectromagnetic energy and/or the heat generated by the resistive shield52 to the surrounding body tissue along the length of the lead 48.

FIG. 8 is a transverse cross-sectional view showing a lead 56 inaccordance with another illustrative embodiment having a gradual changein resistivity across its width. In the embodiment of FIG. 8, the lead56 includes a single conductor 58 having a variable resistivity acrossits width. As indicated generally by reference arrow 60, for example,the resistivity of the conductor 58 can vary across its width such thatthe resistivity is greatest at the outer surface 62 of the lead 56 wherethe lead 56 contacts the surrounding body tissue. In some embodiments,the resistivity of the lead 56 continuously increases from a centerportion 64 of the conductor 58 to the outer surface 62. In otherembodiments, the resistivity may increase at one or more finitelocations across the width of the lead 56.

During an MRI scan, the increased resistivity towards the outer surface62 of the lead 56 serves to dissipate the RF energy received from theMRI device at or near the outer surface 62 along the length of the lead56, thus minimizing the amount of energy transmitted into the interiorof the lead 56. This attenuation of the RF energy at or near the outersurface 62 prevents alternating currents from being transmitted throughthe interior conductor 58 to the electrodes located at the lead tip.

FIG. 9 is a transverse cross-sectional view showing a lead 66 inaccordance with another illustrative embodiment having multiple layersof conductors each with a different resistivity. As shown in FIG. 9, thelead 66 includes an inner conductor 68 surrounding radially by a numberof outer, relatively high resistance conductors 70,72,74. Each of theouter conductors 70,72,74 can have a different resistivity such that theresistance of the lead 66 varies across its width. In some embodiments,and as indicated generally by reference arrow 76, the resistivity ofeach of the outer conductor layers 70,72,74 may successively increaseacross the width of the lead 66 such that the resistivity is greatest ator near the outer surface 78 of the lead 66. In certain embodiments, forexample, a first outer conductor layer 70 may have a first resistivity,a second outer conductor layer 72 may have a second resistivity greaterthan the first resistivity, and a third outer conductor layer 74 mayhave a third resistivity greater than the first and secondresistivities. The number and arrangement of the conductor layers maydiffer, however. For example, while three outer conductor layers70,72,74 are depicted in FIG. 9, in other embodiments a greater orlesser number of outer conductor layers each having a successivelylarger resistivity towards the outer surface 78 may be provided todissipate RF energy received on the lead 66 during an MRI scan.

Although FIGS. 8 and 9 illustrate embodiments in which the leadresistivity varies either continuously or at one or more finitelocations across the width of the lead 56,66, other embodiments in whichthe impedance varies along all or a portion of the length of the lead56,66 are also possible. In some embodiments, for example, the impedanceof the lead 56,66 increases along the length of the lead 56,66 such thatthe distal portion of the lead has a greater impedance than at theproximal portion of the lead. The change in impedance along the lengthof the lead can be achieved by the selection of materials having aparticular characteristic (e.g., a high dielectric, resistivity, etc.),by the construction of the lead (e.g., inductance), by the dimensions ofthe lead (e.g., surface area of the lead), as well as other factors.Creating impedance discontinuities along the length of the lead bychanging the impedance of the lead along the lead length has an effecton the energy pickup of the lead during an MRI scan. In someembodiments, these discontinuities can be distributed along the lengthof the lead so as to prevent a standing wave from being generated alongthe length of the lead, thus minimizing tissue heating at the leadelectrode.

FIG. 10 is longitudinal cross-sectional view showing a lead 80 inaccordance with another illustrative embodiment having an insulatorbetween the resistive shield and the inner conductor. FIG. 11, in turn,is a transverse cross-sectional view showing the lead 80 across line11-11 in FIG. 10. The lead 80 is similar to the lead 14 described withrespect to FIGS. 3-4, including an inner conductor core 82 that can beused as an electrical conduit for supplying energy to one or moreelectrodes on the lead 80, and an outer resistive shield 84 having arelatively high resistance compared to the resistance of the innerconductor core 82 for dissipating RF energy along the length of the lead80.

In the embodiment of FIGS. 10-11, the lead 80 further includes a layerof insulation 86 disposed between the outer resistive shield 84 and theinner conductor core 82. The layer of insulation 86 is configured toelectrically isolate the inner conductor core 82 from RF energy receivedon the outer resistive shield 84. An example of a layer of insulation 86suitable for electrically isolating the inner conductor core 80 is athin layer less than or equal to about 10 mils. If another insulationlayer or coating is paced about the resistive shield 84, then the layerof insulation 86 employed may be thinner, in some embodiments less thanor equal to about 1 mil thickness. In certain embodiments, the outerdiameter of the lead 80, including the inner coil conductor 82, theresistive shield 84, and the insulation 86 is about 50 to 100 mils.

In various embodiments, the resistive shielded wire can be wound to makea coiled conductor, which adds further impedance to the lead byincreasing the inductance. In the embodiment of FIG. 3, for example, theconductor 40 and resistive shield 42 can be helically coiled, similar tothe illustrative lead 118 discussed further herein, for example, withrespect to FIG. 18, thus adding an inductance to the conductor 40. Insome embodiments, the resistive shielded wire used for coil constructionmay be relatively thin (e.g., less than 10 mils). In some embodiments,the coiled conductor can be inserted into insulation tubing or sheathing(e.g., 10 mil insulative tubing) to prevent the coil conductor fromcontacting the tissue and blood at the implantation site. If each of thewires forming the conductor has a layer of insulation, then theinsulation tubing or sheathing placed about the coil conductor isgenerally very thin (e.g., not more than about 1 mil).

FIG. 12 is a longitudinal cross-sectional view showing a lead 88 inaccordance with another illustrative embodiment having a number ofresistive shields spaced apart and electrically isolated from each otheralong the length of the lead. As shown in FIG. 12, the lead 88 issimilar to that shown in FIG. 10, including an inner conductor core 90that can be used as an electrical conduit for supplying energy to one ormore electrodes on the lead 88, and a layer of insulation 92 radiallysurrounding the inner conductor core 90.

In the embodiment of FIG. 12, the lead 88 further includes a number ofouter resistive shields 94 a,94 b,94 c radially disposed about the layerof insulation 92 and the inner conductor core 90. Each of the outerresistive shields 94 a,94 b,94 c can comprise a layer or coating ofmaterial having a resistance that is relatively large in comparison tothe resistance of the inner conductor core 90. In some embodiments, forexample, the ratio of the resistance of one of the outer resistiveshields 94 a,94 b,94 c to the inner conductor core 90 can be in therange of between about 2 to 10.

The outer resistive shields 94 a,94 b,94 c each extend along a portionof the length of the lead 88, and are separated from each other via anumber of small gaps G, as shown. The gap G between each longitudinallyadjacent shield 94 a,94 b,94 c can be sufficient such that each shield94 a,94 b,94 c is electrically isolated from the other shields 94 a,94b,94 c. In some embodiments, for example, the outer resistive shields 94a,94 b,94 c can be separated from each other by a gap G of approximately4 mm to 5 mm. In other embodiments, the gap G separating each of theouter resistive shields 94 a,94 b,94 c may be greater or lesserdepending on the electrical characteristics of the shields 94 a,94 b,94c (e.g., the material and thickness of the shields 94 a,94 b,94 c), theamount of RF energy received on the lead 88, as well as other factors.

The length L of each of the resistive shields 94 a,94 b,94 c can beselected to detune sections of the shields 94 a,94 b,94 c and preventresonance based on the frequency of the RF energy provided by the MRIdevice. In some embodiments, for example, each of the outer resistiveshields 94 a,94 b,94 c has a length L that is less than or equal to ¼ ofthe wavelength of the RF energy received on the lead 88, thus detuningeach of the shields 94 a,94 b,94 c. In use, the picked up energy can beevenly distributed along the length of the lead (and dissipated evenlyin the resistive material) instead of concentrating near the ends ofeach shield 94 a,94 b,94 c, which, in turn, can capacitively coupled toan adjacent shield 94,94 b,94 c and travel to the lead tip. The gaps Galso serve to prevent the picked up energy from traveling to the end ofthe lead and dissipating at the location where the lead electrodecontacts the surrounding body tissue, which can cause a temperature risein the body tissue at this location.

FIG. 13 is another longitudinal cross-sectional view of the lead 88 ofFIG. 12, showing the energy flow path of the RF electromagnetic energyreceived by the lead 88 in the presence of an MRI field. As shown inFIG. 13, RF energy transmitted into the patient's body during an MRIscan is received on each of the outer restive shields 94 a,94 b,94 c.Due to the relatively high resistance of the shields 94 a,94 b,94 c, andas indicated generally by reference arrows 98, the RF energy isdissipated at or near the surface of the lead 88 along only the length Lof each shield 94 a,94 b,94 c. The small gap G between each of theshields 94 a,94 b,94 c prevents the RF energy induced on one of theshields (e.g., shield 94 b) from being transmitted to an adjacent shield(e.g., shield 94 c). As a result, the flow of RF energy on one sectionof the lead 88 is interrupted and prevented from being transmitted alongthe entire length of the lead 88 to the lead tip. The interrupted RFenergy is thus reflected back due to the mismatch in the impedance andis eventually dissipated within the resistive shield 94 a,94 b,94 c.

FIG. 14 is a longitudinal cross-sectional view showing a lead 100 inaccordance with another illustrative embodiment having ahelically-shaped inner conductor coil surrounded radially by a resistiveshield. As shown in FIG. 14, the lead 100 is similar to the lead 80described with respect to FIGS. 10-11, with like elements labeled inlike fashion in the drawings. In the embodiment of FIG. 14, however, theinner conductor 102 is a helically-shaped conductor coil that extendsthrough the interior of the lead 100, and which adds inductance to thelead 100 at MRI RF frequencies, thus increasing the impedance andinhibiting transmission of the RF energy along the length of the lead100. In contrast to the outer resistive shield 84, the conductor coil102 is fabricated from an electrically conductive, low resistancematerial configured to facilitate low-energy transmission of therapeuticenergy to the electrodes on the lead 100. In some embodiments, forexample, the inner conductor coil 102 is fabricated from a silver filledMP35N wire containing approximately 28% to 30% silver whereas the outerresistive member 84 comprises different, more resistive material.

In the embodiment of FIG. 14, the outer resistive shield 84 may extendcontinuously and uninterrupted along all or a portion of the length ofthe lead 100. In another illustrative lead 104 depicted in FIG. 15, thelead 104 includes a number of outer resistive shields 106 a,106 b,106 ceach spaced apart and electrically isolated from each other along thelength of the lead 104 via a number of small gaps G, as shown. Thelength L of each of the outer resistive shields 106 a,106 b,106 c can beselected to detune the lead 104 and prevent resonance based on thefrequency of the RF energy provided by the MRI device. In someembodiments, for example, each of the outer resistive shields 106 a,106b,106 c has a length L that is less than or equal to ¼ of the wavelengthof the RF energy received on the lead 104.

FIG. 16 is a longitudinal cross-sectional view showing a lead 106 inaccordance with another illustrative embodiment having ahelically-shaped inner conductor coil surrounded radially by ahelically-shaped resistive coil. The lead 106 is similar to the lead 100described with respect to FIG. 14, including a helically-shaped Innerconductor coil 108 that can be used as an electrical conduit forsupplying energy to one or more electrodes on the lead 106, a layer ofinsulation 110 radially surrounding the inner conductor coil 108, and anouter resistive shield 112 having a relatively high resistance comparedto the resistance of the inner conductor coil 108 for dissipatingabsorbed RF energy along the length of the lead 106. In someembodiments, the inner conductor coil 108 is a single-filar wire coil.In other embodiments, the inner conductor coil 108 is a multi-filar wirecoil.

In the embodiment of FIG. 16, the outer resistive shield 112 comprises ahelically-shaped resistive coil that radially surrounds the innerconductor coil 108 and the layer of insulation 110. The resistive coil112 has a relatively high resistance in comparison to the resistance ofthe inner conductor coil 108 to facilitate dissipation of RF energyreceived on the lead 106 into the surrounding body tissue along thelength of the lead 106. In sonic embodiments, for example, the ratio ofthe resistance of the resistive coil 112 to the resistance of the innerconductor coil 108 may be in the range of between about 2 to 10. In oneembodiment, the inner conductor coil 102 is fabricated from a silverfilled MP35N wire containing approximately 28% to 30% saver whereas theouter resistive member 84 comprises different, more resistive materialsuch as a pure MP35N.

In the embodiment of FIG. 16, the resistive coil 112 may extendcontinuously and uninterrupted along all or a portion of the length ofthe lead 106. In another Illustrative lead 114 depicted in FIG. 17, thelead 114 includes a number of resistive coils 116 a,116 b,116 c eachspaced apart and electrically isolated from each other along the lengthof the lead 114 via a number of small gaps G, as shown. The length L ofeach of the resistive coils 116 a,116 b,116 c can be selected to detunethe lead 114 and prevent resonance based on the frequency of the RFenergy transmitted by the MRI device. In some embodiments, for example,each of the resistive coils 116 a,116 b,116 c has a length L that isless than or equal to ¼ of the wavelength of the RF energy received bythe lead 114.

FIG. 18 is a longitudinal cross-sectional view showing a lead 118 inaccordance with another illustrative embodiment. As shown in FIG. 18,the lead 118 Includes a helically-shaped conductor coil 120 that extendsalong at least a portion of the length of the lead 118. The conductorcoil 120 is configured as an electrical conduit for supplying energy tothe one or more electrodes on the lead 118. In certain embodiments, theconductor coil 120 is encased within an outer member 121 which serves toradially constrain the conductor coil 120 along the length of the lead118. In some embodiments, for example, the outer member 121 comprises ajacket of silicone or polyurethane disposed radially about the conductorcoil 120.

FIG. 19 is a transverse cross-sectional view showing the configurationof the conductor coil 120 of FIG. 18 in greater detail. As further shownin FIG. 19, the conductor coil 120 includes an inner conductive core 122and an outer resistive shield 124 radially disposed about the inner core122. The resistive shield 124 can be formed integrally with the innerconductive core 122 (e.g., by a co-extrusion process), and comprises amaterial having a resistance that is greater than the resistance of theconductor core 122. In some embodiments, for example, the ratio of theresistance of the resistive shield 124 to the resistance to theconductor core 122 can be in the range of between about 2 to 10.

In the embodiment of FIGS. 18-19, the conductor coil 120 furtherincludes a layer or coating of insulation 126 disposed between the innerconductor core 122 and the outer resistive shield 124. In someembodiments, a second layer or coating of insulation 128 may also beprovided over the outer, resistive shield 124 to further insulate theshield 124.

If certain embodiments, and as further shown in FIG. 20, the first layeror coating of insulation 126 can be eliminated between the innerconductor core 122 and the outer resistive shield 124. If, for example,the skin depth of the resistive shield 124 is sufficiently large (e.g.,greater than 4), than the first layer or coating of insulation 126 maybe eliminated since the alternating currents produced by the RF energyare unable to penetrate sufficiently through the depth of the shield 124due to the decline in current density at the interface between theshield 124 and the inner conductor core 122.

In those embodiments in which the conductor is coiled, the geometry ofthe coil conductor, including the outer diameter and pitch of the coilconductor, can be configured so as to increase the inductance and hencethe impedance of the lead in order to inhibit the transfer of energyalong the length of the lead. In some embodiments, for example, theinductance of the coil conductor can be increased by increasing thenumber of coil turns (e.g., by decreasing the pitch of the coilconductor), by increasing the outer diameter of the coil conductor, orby a combination of both. Since the impedance of a coil conductor isbased in part on its inductance, increasing the inductance of the coilconductor by increasing the number of coil turns and/or increasing theouter diameter of the conductor results in an increase in the overallimpedance of the conductor. Since the overall impedance of the lead atRF frequencies in MRI applications (e.g., 64 MHz) is partly a functionof the inductance of the lead, this increase in the coil conductorinductance results in a decrease in the transfer of absorbed RF energyby the lead along its length towards the lead electrode.

In some embodiments, the coil conductor can comprise a helically-shapedwire coil conductor having a width of about 0.005 inches and a coildiameter (i.e., outer diameter) in the range of between about 0.016inches to about 0.066 inches. In certain embodiments, for example, thecoil conductor can have a coil diameter of at least 0.036 inches, 0.050inches, 0.060 inches, or 0.066 inches. Other coil diameterconfigurations, however, are possible.

The pitch of the coil conductor can also be configured so as to increasethe inductance and hence the impedance of the lead. In some embodimentsthe pitch of conductor can be in the range of between about 0.005 inchesto 0.160 inches. Other coil pitch configurations, however, are possible.In general, as the coil pitch increases, the heating at the leadelectrode also increases. For a 0.035 inch outer diameter coil, and insome embodiments, the pitch of the conductor should be no greater thanabout 0.008 inches, and more specifically, about 0.005 inches. Forlarger outer diameter coils, however, the minimum pitch can be larger,in some embodiments up to and including about 0.025 inches.

A strong interdependence exists between the coil pitch and the coildiameter of the coil conductor as the coil pitch increases and the coildiameter decreases. FIG. 21 is a chart showing the interdependence ofcoil pitch and coil diameter on the amount of absorbed RF energytransferred by a helically-shaped wire coil conductor to a distal leadtip. FIG. 21 may represent, for example, the peak specific absorptionrate (SAR) as a function of coil pitch and coil diameter for a 0.036inch coil diameter wire conductor and a 0.066 inch coil diameter wireconductor, each conductor having a length of about 50 cm and comprisingan MP35N material. As the coil pitch of each of the conductorsincreases, the peak SAR, representing the amount of RF energy absorbedby the conductor, increases as a quadratic function. As shown in FIG.21, a coil pitch greater than about 0.020 inches (20 mils) for a 0.036inch wire coil, and a coil pitch greater than about 0.050 inches (50mils) for a 0.066 inch wire coil, results in a significant rise in peakSAR that can increase the temperature of the body tissue at the leadelectrode. As further shown in FIG. 21, at equivalent coil pitch values,the peak SAR for the larger coil diameter conductor is generally smallerthan the peak SAR for the smaller coil diameter conductor.

Other design parameters of the lead can also be selected so as to reducelead heating by the lead. In some embodiments, for example, theinsulation provided about the coil conductor can be selected so as toreduce lead heating. The insulation thickness changes how much energy iscoupled into or out of the surrounding body tissue along the length ofthe lead. In some cases, a relatively thin insulation, or insulationswith higher dielectric constants, can minimize the temperature rise of alead at the point of contact with the body tissue. An example of arelatively thin insulation for a coiled wire conductor has a wallthickness of less than about 0.015 inches, although other insulationthicknesses are possible.

Various modifications and additions can be made to the exemplaryembodiments discussed without departing from the scope of the presentinvention. For example, while the embodiments described above refer toparticular features, the scope of this invention also includesembodiments having different combinations of features and embodimentsthat do not include all of the described features. Accordingly, thescope of the present invention is intended to embrace all suchalternatives, modifications, and variations as fall within the scope ofthe claims, together with all equivalents thereof.

1. An implantable medical lead for use in a magnetic resonance imaging(MRI) environment, the lead comprising: a lead having a proximal portionconfigured to be coupled to a pulse generator, a distal portion havingan electrode, and a conductor wire that extends from the proximalportion to the distal portion to electrically connect with the electrodefor conducting energy between the electrode and the pulse generator; thelead having a resistivity that increases across a width of the leadbetween a center portion of the conductor wire and an outer portion ofthe lead such that the resistivity is greatest at the outer surface ofthe lead; and wherein the outer portion of the lead is configured todissipate RF electromagnetic energy received by an MRI device along alength of the lead.
 2. The lead of claim 1, wherein the resistivityincreases at a plurality of finite locations across the width of thelead.
 3. The lead of claim 1, wherein the lead comprises a plurality ofconductive layers radially surrounding the conductor wire.
 4. The leadof claim 3, wherein the conductive layers successively increase inresistivity across the width of the lead.
 5. The lead of claim 3,wherein the plurality of conductive layers comprises a first outerconductor layer with a first resistivity, a second outer conductor layerwith a second resistivity greater than the first resistivity, and athird outer conductor layer with third resistivity greater than thefirst and second resistivities.
 6. The lead of claim 1, wherein theconductor wire is surrounded radially by a plurality of outer resistiveshields that successively increase in resistivity.
 7. The lead of claim1, wherein the conductor wire is the only conductor wire that extendsalong the length of the lead, the conductor wire having a variableresistivity across its width that increases from the center portion ofthe conductor wire.
 8. The lead of claim 7, wherein the conductor wirecontinuously increases in resistivity from the center portion of theconductor wire.
 9. The lead of claim 1, wherein the outer surface of theconductor wire is the outer surface of the lead.
 10. The lead of claim1, wherein the lead is configured to attenuate RF energy from an MRIscan by the increasing resistivity across the width of the leadinhibiting alternating currents from being transmitted to the centerportion of the conductor wire and to the electrode on the distal portionof the lead.
 11. An implantable medical lead for use in a magneticresonance imaging (MRI) environment, the lead comprising: a lead havinga proximal portion configured to be coupled to a pulse generator, adistal portion having an electrode, and a conductor wire that extendsfrom the proximal portion to the distal portion to electrically connectwith the electrode for conducting energy between the electrode and thepulse generator; the conductor wire having a resistivity that increasesacross a width of the conductor wire between a center portion of theconductor wire and an outer portion of the conductor wire such that theresistivity is greatest at the outer portion of the conductor wire; andwherein the outer portion of the conductor wire is configured todissipate RF electromagnetic energy received by an MRI device.
 12. Thelead of claim 11, wherein the resistivity increases along the width ofthe conductor wire at a plurality of finite locations.
 13. The lead ofclaim 11, wherein the conductor wire comprises a plurality of conductivelayers radially surrounding the center portion of the conductor wire.14. The lead of claim 13, wherein the conductive layers successivelyincrease in resistivity across the width of the conductor wire.
 15. Thelead of claim 13, wherein the plurality of conductive layers comprises afirst outer conductor layer with a first resistivity, a second outerconductor layer with a second resistivity greater than the firstresistivity, and a third outer conductor layer with third resistivitygreater than the first and second resistivities.
 16. The lead of claim11, wherein the conductor wire comprises an inner wire core surroundedradially by a plurality of outer resistive shields that successivelyincrease in resistivity.
 17. The lead of claim 11, wherein the conductorwire is the only conductor wire that extends along the length of thelead.
 18. The lead of claim 11, wherein the conductor wire continuouslyincreases in resistivity from the center portion of the conductor wireto an outer surface of the conductor wire.
 19. The lead of claim 11,wherein an outer surface of the conductor wire defines an outer surfaceof the lead.
 20. The lead of claim 11, wherein the conductor wire isconfigured to attenuate RF energy from an MRI scan by the increasingresistivity across the width of the conductor wire inhibitingalternating currents from being transmitted to the center portion of theconductor wire and to the electrode on the distal portion of the lead.